Televised live on ESPN, the wiener wolf-down is the Super Bowl of Speed Eating. Watching the annual Coney Island frank fest is both riveting and repulsive as men and women compete for prize money ($10,000 to each first place finisher) and bragging rights for their championship stomachs.

But what price do these "athletes" pay for their gluttonous pig-outs and 15 minutes of frankfurter fame?

"I know it's totally not healthy, but neither is football right now," says Dave "Coondog" O'Karma, who competed at Coney Island in 2001 (finishing seventh) and 2002. He now runs All Pro Eating, which holds "picnic-style" eating contests (competitors must eat the food as they would at a picnic and not dunk it in water or mash it up in order to down it faster).

O'Karma, who is 56, competed against kids half his age. But he says he could always eat a lot of food really fast and never really struggled with his weight.

He did struggle with one contest cornerstone, though. While the former champ once chomped down 27 Krispy Kreme donuts in a minute and a half on live TV, hot dogs nearly did him in.

"I had a hard time with the garlic and the sodium," he says, admitting he would feel "incredibly nauseous and thirsty" afterwards.

Even so, O'Karma says the speed eating contests become a "war between the competitive spirit and common sense." Competitive eaters are not thinking about the health consequences 20 years down the road, he admits.

How do speed eaters do it?

The one study done on a competitive male eater seems to suggest the man had the ability to expand his stomach many times more than a larger person, says Dr. Alphonso Brown, a gastroenterologist at Beth Israel Deaconess Medical Center in Boston. (Brown was not involved in the study.)

"Competitors can train their stomach to do this," he says.

Not only can speed eaters' stomachs expand and hold tremendous amounts of food, they also have little to no peristalsis, the rhythmic muscular contractions that move food through the digestive system, explains Brown. This means food can sit in their super-sized stomachs longer than normal eaters before emptying into the small intestine.

"Competitive eaters also appear to lack the signal that tells the brain when the stomach is full," he says. So they can scarf down a world record 68 franks and buns in 10 minutes without feeling full and uncomfortable.

As for the long-term health effects, speed eaters get way too much protein, fat, and sodium. Brown says the closest comparison is studies of people who have followed an Atkins-style diet.

This research suggests that people on high-protein, high-fat eating plans may be at greater risk for high blood pressure, kidney disease, high cholesterol, and possibly diabetes. Plus eating large amounts of red meat may boost the odds for colon cancer.

In addition, once they quit being gustatory athletes, "it's unclear if their stomachs would return to normal," Brown points out.

Considering the potential health risks (not to mention a hot dog's infamous ingredients), why would someone participate in such a gluttonous event?

O'Karma says speed-eating contests make them feel like they're champions, even for a day or an hour, pointing out that most competitors are average people in it for the fun, the camaraderie, the competitive spirit, and of course, the attention.

"It sure beats everyday living," he says. You feel like a celebrity up on the stage, and that gets very addicting."